Enhanced Community First Responder System Evaluation in Singapore

Официальное название

Evaluation of an Enhanced Community First Responder Support System to Improve Bystander Cardiopulmonary Resuscitation Quality for Patients Experiencing Out-of-hospital Cardiac Arrest

Обзор

The rise in out-of-hospital cardiac arrest (OHCA) cases in Singapore highlights the need for effective bystander cardiopulmonary resuscitation (BCPR). Despite many lay responders performing CPR, survival rates with good neurological outcomes have not significantly improved, prompting research into the quality of CPR as a critical factor. The study by Gallagher EJ et al. showed a significant survival improvement with high-quality CPR. To address this, the Unit of Pre-hospital and Emergency Research (UPEC) trained thousands of community first responders (CFRs) in simplified CPR techniques using hands-only and DA-CPR methods. A significant innovation is the CPRcard®, developed by Laerdal in Norway, which offers real-time feedback on the quality of chest compressions. However, only 36% of CFRs using the CPRcard® achieved the desired compression standards, indicating room for improvement. The study proposes enhancing CFR support with information communication technology (ICT), enabling two-way audio and one-way video communication between CFRs and dispatchers. This aims to reduce stress among responders, increase their willingness to engage with OHCA alerts, and improve CPR quality. The clinical trial in Singapore will compare the current system against the enhanced CFR support system (eCSS), focusing on the real-time relay of CPR performance data, communication ease, and implementation factors. The high-quality CFR and OHCA registries in Singapore provide a robust setting for this research, aiming to enhance CPR delivery and improve OHCA outcomes through technology and real-time support.

Вмешательства

• Устройство CPRCard + TCPR Link App and Web
  Application that allows responder to perform CPR with two-way audio communication and one-way video streaming to SCDF Dispatcher
• Устройство CPRCard Only
  Control arm with standard care of procedure that Bystander using CPRCard only

Первичные конечные точки

• Good Chest Compression Depth (4-6cm) [Срок оценки: Throughout chest compression before handing over to EMS (up to 24 hours)]

Вторичные конечные точки (1)

• Survivor discharging rate [Срок оценки: Throughout Hospital Admission (up to 1 year)]

Критерии участия

Критерии включения

• 18 years old and above
• SCDF registered CFRs
• Trial dispatchers with an active account of myResponder® app on their mobile phones

Критерии исключения

• The CFRs who are pregnant
• Experiencing any serious physical Conditions
• Mental Health Conditions

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Организация здравоохранения

Центры проведения

Сингапур · 1 центр

• Duke-NUS Medical School — Singapore

Публикации

• White AE, Ho AF, Shahidah N, Asyikin N, Liew LX, Pek PP, Kua JP, Chia MY, Ng YY, Arulanandam S, Leong SB, Ong ME. An essential review of Singapore's response to out-of-hospital cardiac arrests: improvements over a ten-year period. Singapore Med J. 2021 Aug;62(8):438-443. doi: 10.11622/smedj.2021114. PMID 35001113
• Ho AFW, Lim MJR, Earnest A, Blewer A, Graves N, Yeo JW, Pek PP, Tiah L, Ong MEH; Singapore PAROS Investigators. Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study. Lancet Reg Health West Pac. 2022 Dec 28;32:100672. doi: 10.1016/j.lanwpc.2022.100672. eCollection 2023 Mar. PMID 36785853
• Chan PS, McNally B, Tang F, Kellermann A; CARES Surveillance Group. Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation. 2014 Nov 18;130(21):1876-82. doi: 10.1161/CIRCULATIONAHA.114.009711. PMID 25399396
• Gallagher EJ, Lombardi G, Gennis P. Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest. JAMA. 1995 Dec 27;274(24):1922-5. PMID 8568985
• Bobrow BJ, Vadeboncoeur TF, Stolz U, Silver AE, Tobin JM, Crawford SA, Mason TK, Schirmer J, Smith GA, Spaite DW. The influence of scenario-based training and real-time audiovisual feedback on out-of-hospital cardiopulmonary resuscitation quality and survival from out-of-hospital cardiac arrest. Ann Emerg Med. 2013 Jul;62(1):47-56.e1. doi: 10.1016/j.annemergmed.2012.12.020. Epub 2013 Mar 7. PMID 23465553
• Sasson C, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):63-81. doi: 10.1161/CIRCOUTCOMES.109.889576. Epub 2009 Nov 10. PMID 20123673
• Hollenberg J, Herlitz J, Lindqvist J, Riva G, Bohm K, Rosenqvist M, Svensson L. Improved survival after out-of-hospital cardiac arrest is associated with an increase in proportion of emergency crew--witnessed cases and bystander cardiopulmonary resuscitation. Circulation. 2008 Jul 22;118(4):389-96. doi: 10.1161/CIRCULATIONAHA.107.734137. Epub 2008 Jul 7. PMID 18606920
• Song J, Guo W, Lu X, Kang X, Song Y, Gong D. The effect of bystander cardiopulmonary resuscitation on the survival of out-of-hospital cardiac arrests: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2018 Oct 11;26(1):86. doi: 10.1186/s13049-018-0552-8. PMID 30309373

Идентификаторы

NCT: NCT06530433 · CIRB 2015-2475

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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